Keto-adapt your clients in 3 months in 8 easy steps

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1 Keto-adapt your clients in 3 months in 8 easy steps Rob Verkerk PhD Founder, executive & scientific director Alliance for Natural Health International ANH International

2 Personal journey

3 What we re not talking about Upon examination of the literature, the majority of studies report decreases in fat-free mass in individuals following a ketogenic diet. However, some confounding factors exist, such as the use of aggressive weight loss diets and potential concerns with fat-free mass measurement. A limited number of studies have examined combining resistance training with ketogenic diets, and further research is needed to determine whether resistance training can effectively slow or stop the loss of fat-free mass typically seen in individuals following a ketogenic diet. Mechanisms underlying the effects of a ketogenic diet on fat-free mass and the results of implementing exercise interventions in combination with this diet should also be examined. Tinsley GM, Willoughby DS. Fat-Free Mass Changes During Ketogenic Diets and the Potential Role of Resistance Training. Int J Sport Nutr Exerc Metab Aug 12. [Epub ahead of print]

4 Multi-modal interventions Betz MJ, Enerbäck S. Front Endocrinol Nov 29; 2: 86.

5 Diet or state? * Ketosis: long-term or cyclic? * KD, Low Carb diet, Very Low Carb, Cyclic KD * Effects on body composition: fat vs muscle mass * CKD + Intermittent Fasting + Physical Activity * Nutritional ketosis vs starvation-induced ketosis

6 Traits among the keto-adapted * Can readily burn fats for fuel * Regularly practice caloric restriction and intermittent fasting * Physically active * Diet is anti-inflammatory and loaded with phytonutrients from the 6 main colour groups of the phytonutrient spectrum * Bulk of their diet energy in keto phase from fat * Metabolic risk = v low as measured by bloods or BC (muscle/ adipose/visceral fat ratios) * Nutrition and lifestyle adapted around genetic and other limitations * Metabolic + psychoemotional flexibility

7 Metabolic fuelling basics Metabolic flexibility is key

8 Your 3 energy systems 1. Phosphagen or ATP-CP system 2. Anaerobic / Fast glycolysis 3. Aerobic / Slow glycolysis + Krebs/TCA cycle + Electron Transport Chain (oxidative phosphorylation)

9 Theoretical E yield * Creatine phosphate: alactic/anaerobic 1 ATP * Glucose: lactic acid/anaerobic 2 ATP * Glucose: lactic acid/aerobic 36 ATP * Fatty acids (beta-oxidation): alactic/aerobic 129 ATP Mitochondria Bacterial origin Average 1000 in each muscle cell Regular activity generates new mitochondria

10 Energy from your fuel stores

11 Threshold training * Aerobic metabolism * Anaerobic threshold * Lactate threshold * Anaerobic metabolism

12 Training for your 3 E systems Phosphagen system * 2 sets of 8 x 5 seconds at maximal with 3:00 passive rest and 5:00 rest between sets * 5 x 10 seconds at maximal with 3:00 4:00 passive rest Anaerobic (fast glycolysis) * Sprint-8 type: 8 10 x 30 seconds fast with 1:00 active recovery * 4 x 1:30 fast with 3:00 active recovery Aerobic * Long, steady activity * 60+ (pref 90+) minutes at 70% 75% maximum heart rate * 15- to 20-minute tempo workout at lactate threshold intensity (about 80% 85% maximum HR) * 5 x 3:00 at 95% 100% maximum heart rate with 3:00 active recovery

13 Contradications for KD * History of pancreatitis * Active gall bladder disease * Impaired liver function * Impaired fat metabolism/digestion * Poor nutritional status * Gastric bypass surgery * Abdominal tumours * Decreased gastrointestinal motility (e.g. in conjunction with conventional cancer treatment and associated drugs) * History of kidney failure

14 Helpful hardware (mostly optional) * * * * * Food balance Body composition scale (e.g. Tanita BC 545N) Physical activity monitor (e.g. Suunto Ambit) Reference book (e.g. Volek & Phinney, 2011) Ketonix device (optional)

15 Ketonix

16 ANH Food4Health plate anhinternational.org #Food4Health

17 Additional resources

18 Classic KD 1500 Energy kcal/d % kcal Grams Carbs Protein Fat Total

19 Early adaptation phase * Know how you will feel * Strict ketosis phase: 30 days * Minimize activity in early adaptation phase * Don t give up!

20 Carb-refeed phase * Don t start until Month 2 * Deplete and replete glycogen stores * Key before endurance activity * Up-regulate hormones and thyroid activity * Gives psychological "break" that increases overall compliance on CKD * Enjoy!

21 4 essentials to Cyclic Keto LS 1. Understand your body and your body composition - SNP, genetic/polymorphism tests (e.g. DNA Life, Nordic Labs) - current BC, metabolic risk, health status; antecedents, triggers, perpetuators (e.g. use FM Matrix) 2. Choose your physical activities 3. Clear your house of refined carbs, grain products and stock with healthy fats (Extra Virgin Coconut Oil, Extra Virgin Olive Oil; seeds, tree nuts) 4. Learn to plan: nutrition + activity + rest (BTS)

22 8 steps to CKLS (1-4) 1. Set your goals 2. Preparation: baseline BC, go entirely grain-free during KD phase; gluten-containing grain-free in glycogen repletion phase 3. Timing/Planning: Maintain >5h between food; >12 h fasts 6 d/w; don t eat within 2 h of bed, select carb refeed times carefully 4. Sleep: Plenty (6-9h, depending on individual, stress, etc)

23 8 steps to CKDLS (5-8) 5. Food & water: Use F4H plate as your average plan - maintain dietary diversity 6. Physical activity: Alternate resistance/strength and endurance/cv training, train twice weekly in fasted state; include 1-3 sessions HIIT/w 7. Monitoring: Monitor body composition, dietary intake and physical activity 8. Adjust/fine-tune your programme - We re each individual!

24 ANHInternational